Alabama Medicaid pays for in-home personal care and related services through 5 programs, including the Elderly and Disabled (E&D) Waiver and the Alabama Community Transition (ACT) Waiver. The Alabama Medicaid Agency oversees the waivers. The Department of Senior Services operates E&D, ACT, and TA; Rehabilitation Services operates SAIL; the Department of Mental Health operates ID, LAH, and the Community Waiver Program. Confirm adult state plan personal care and EVV requirements for E&D and ACT with the Alabama Medicaid Agency.
Which Alabama waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Elderly and Disabled (E&D) Waiver
Population
People who are elderly and/or disabled, meet the nursing facility level of care, and have income up to $2,982 per month and resources up to $2,000.
People with disabilities or long-term illnesses who live in an institution, meet nursing facility level of care, and want to move home or to the community.
To bill Medicaid for home care you need a state license, a Type 2 NPI, state Medicaid enrollment and screening, waiver or managed care contracts, EVV and authorizations.
Private pay means higher rates and fast payment; Medicaid means steady volume at state-set rates with authorizations and EVV. Compare rates, cash timing and admin before you mix them.
Track units remaining, the end date and the service code for every client, and check them before each schedule change. Hours over the cap are unbillable.
Four units equal one hour. How to convert units to hours, the common HCPCS codes, how states round partial units, and how to stay inside the authorization.
These free tools are made by the team behind Caregiver Scheduling,
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